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. 2021 Apr:65:101340.
doi: 10.1016/j.trim.2020.101340. Epub 2020 Oct 15.

Donor specific anti-HLA antibodies and cardiac allograft vasculopathy: A prospective study using highly automated 3-D optical coherence tomography analysis

Michal Pazdernik  1 , Helena Bedanova  2 , Zhi Chen  3 , Josef Kautzner  4 , Vojtech Melenovsky  4 , Ivan Malek  4 , Antonij Slavcev  5 , Michaela Bartonova  5 , Vladimir Karmazin  4 , Tomas Eckhardt  4 , Ales Tomasek  2 , Eva Ozabalova  6 , Tomas Kovarnik  7 , Peter Wohlfahrt  8 , Milan Sonka  3
Affiliations

Donor specific anti-HLA antibodies and cardiac allograft vasculopathy: A prospective study using highly automated 3-D optical coherence tomography analysis

Michal Pazdernik et al. Transpl Immunol. 2021 Apr.

Abstract

Introduction: Recent studies suggested potential positive correlations between HLA-specific antibodies and development of cardiac allograft vasculopathy (CAV).

Methods: This prospective two-center study investigated early progression of CAV by coronary optical coherence tomography in 1 month and 12 months after heart transplantation (HTx) in 104 patients. Detection and characterization of donor specific (DSA) and MHC class-I polypeptide-related sequence A (MICA) antibodies were performed before, 1, 6 and 12 months after transplantation.

Results: During the first post-HTx year, we observed a significant reduction in the mean coronary luminal area (P < .001), and progression in mean intimal thickness (IT) (P < .001). DSA and anti-MICA occurred in 17% of all patients, but no significant relationship was observed between presence of DSA/anti-MICA and IT progression within 12 months after HTx. In contrast, we observed significant association between presence of DSA (p=0.031), de-novo DSA (p=0.031), HLA Class II DSA (p=0.017) and media thickness (MT) progression.

Conclusion: Results of our study did not identify a direct association between presence of DSA/anti-MICA and intimal thickness progression in an early period after HTx. However, we found significant relationships between DSA and media thickness progression that may identify a newly recognized immune-pathological aspect of CAV.

Keywords: Cardiac allograft vasculopathy; Donor specific antibodies; Heart transplant; Intimal thickness.

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Conflict of interest statement

Conflict of interest: Authors have nothing to disclose.

Figures

Figure 1
Figure 1
Three-dimensional segmentation of luminal (red), intimal (green), and medial (orange) surfaces performed volumetrically in the entire OCT pullback with intimal and medial layer thickness, brightness, and roughness indices calculated in 360 radial directions in each OCT frame. Changes of layer-specific indices were evaluated in a location-specific manner after M1—M12 OCT registration of the paired pullbacks.
Figure 2
Figure 2. Changes in intimal and medial thickness in relation to presence of DSA/anti-MICA in the cohort.
DSA – donor specific antibodies; IT - intimal thickness; anti-MICA – anti-MHC class-I polypeptide-related sequence A; MT – media thickness; μm – micrometres.
See this image and copyright information in PMC

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